Ebola crisis in DRC worsened by conflict and political instability

On May 17, 2026, the World Health Organization declared the Ebola epidemic in eastern Democratic Republic of the Congo (DRC), also persisting in Uganda, a Public Health Emergency of International Concern. The Africa CDC followed suit the next day. On June 5, both institutions launched a six-month joint response plan, calling for $518 million in funding. Caused by the rare Bundibugyo strain, with no approved vaccine or treatment, this 17th outbreak strikes a region already devastated by conflict and destabilized by changes in US aid. This crisis emerges amid heightened instability due to numerous armed groups and ongoing violence. How might this epidemic worsen security and humanitarian frailties in eastern DRC and complicate access to care? What risks does it pose to regional balances in Central Africa? Finally, what does the resurgence of Ebola reveal about the international community’s current capacity to respond to major health crises?

In a context marked by armed conflicts, political instability, and profound economic and social fragility, especially in eastern DRC, how does the Ebola epidemic affect internal stability in affected areas and complicate the establishment of health systems ensuring access to care?

This new Ebola wave arrives in a zone of multiple and structural crisis. Primarily affecting the DRC, this is the 17th epidemic since 1976 (first identification in Yambuku), and this time it is the Bundibugyo strain. Currently, although treatments are being tested, there is no approved vaccine or treatment, with a fatality rate of about one in two infected. The eastern regions—North and South Kivu and Ituri—are particularly vulnerable. Last year, the UN reported one of the worst cholera outbreaks in 25 years. Since 2020, Mpox has been spreading massively, especially since September 2023. Ituri, the epicenter, is one of the most troubled provinces, poorly served by roads, plagued by armed group violence, and hosting nearly a million displaced people in camps. The health crisis thus overlaps with a pre-existing humanitarian and security crisis, fueled by endemic instability and conflict, particularly intense since the M23 offensive in 2023. Local populations face daily uncertainty, regular internal displacement, and overcrowded camps. These conditions favor pathogen resurgence and rapid spread. Moreover, the complex crisis in eastern DRC, with rare calm periods, has severely weakened social fabric and health services, unable to meet basic needs, creating structural dependence on foreign aid. Systemic violence from waves of conflict has deprioritized health and normalized violence, especially against women and children. In this precarious context, a large-scale epidemic compounds the crisis amid security collapse.

National data as of May 31, 2026, recorded 282 confirmed cases, including 42 deaths, after 19 new positive tests. WHO reported 349 suspected cases under surveillance as of June 1, mainly in Ituri province in the health zones of Bunia, Rwampara, and Mongbwalu. Bunia hospital quickly became overwhelmed, requiring peripheral treatment centers. The recovery of four infected health workers offered hope. By June 5, pressure intensified, with about six health centers in Bunia temporarily closed for disinfection, reducing capacity and worrying pregnant women and other patients who received minimal care or were sent home. Ebola also disrupted routine health services.

A major challenge is the lack of coordinated response from Kinshasa in a zone partially occupied by the Rwandan proxy M23 and where numerous armed groups operate for extractive reasons. This reflects the recurring issue of national unity control in a country of nearly 100 million and the effectiveness of basic social and health services. In M23-controlled areas, several cases have been counted. Since the government has not coordinated health response with illegally occupying armed groups, the risk of epidemic spread remains. Negotiations may be underway but have not yet established the necessary health coordination framework. Territorial fragmentation in the east prevents a unified response. Two Ebola treatment centers are reportedly being set up in Goma, the M23/AFC-held capital, with limited capacity, and the armed group claims to have taken the situation seriously and implemented contingency plans. The epidemic also progresses in rebel-held areas. Who controls public health when the state no longer has territorial monopoly?

Community resistance compounds the challenge, similar to 2018-2020. An anti-response protest in Rwampara escalated to the incineration of a suspected case’s body. Distrust and hostility toward medical teams are stability variables in themselves. Community resistance is deeply cultural: refusal to return bodies of Ebola victims to families is seen as unbearable symbolic violence. In eastern DRC societies, funeral rituals, especially bathing and physical contact with the deceased, are spiritual imperatives. Yet these practices are major transmission vectors for Ebola. Resentment in Ituri and Kivu stems from structural suspicion rooted in decades of violence, state abandonment, and perceived predatory external interventions. Thus, health response is easily perceived as a new form of imposed control, fueling rumors and conspiracy theories.

Can the Ebola epidemic have lasting effects on DRC’s relations with neighboring countries? How might this crisis destabilize regional stability in Central Africa?

We are in a situation of high tension and extractivist competition between DRC and its eastern neighbors, especially Rwanda, with sometimes strained relations with Uganda. When an epidemic spreads in a state where part of the territory escapes central control, making a national coordinated response difficult, the response must be transregional or even continental. Africa CDC has indicated about ten vulnerable countries: South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Congo-Brazzaville, Burundi, Angola, Central African Republic, and Zambia, in addition to DRC and Uganda already affected with seven cases. Response capacity varies greatly: Kenya and Ethiopia have relatively stronger health systems and surveillance, with Kenya already setting up quarantine structures, while Central African Republic remains one of the continent’s most fragile states, heavily dependent on external aid. South Sudan combines a serious internal crisis and repercussions from the war in neighboring Sudan. By definition, an epidemic knows no artificial borders; it affects living beings regardless of status. Some are more vulnerable, especially the poor, particularly where borders are extremely porous. Imported cases from Ituri reached North Kivu and Kampala, Uganda, where two travelers returning from DRC tested positive, one deceased. A case was also reported in South Kivu, according to the M23 spokesman, with the patient coming from Kisangani in Tshopo province. This dynamic is accompanied by border closures and diplomatic tensions, not to mention major economic consequences. Uganda suspended flights and passenger transport with DRC on May 21, 2026. Rwanda closed its border with Goma. These unilateral measures hit already tense bilateral relations. Add the entwinement with the eastern conflict, which directly contributes to the epidemic’s spread. It progresses in areas like Goma, captured in late January 2025, and Bukavu, fallen in February 2025, raising fears of regional conflagration. Health thus becomes an additional arena for the Kinshasa-Kigali rivalry, with M23 imposing itself as a de facto public health actor in territories it controls. Facing this cross-border risk, the East African Community called on its member states to activate laboratory networks and strengthen border surveillance, holding an extraordinary ministerial meeting of health ministers on June 1-2, 2026. Officials said ministers committed to harmonize health checks at entry points without closing borders, create a regional technical working group to coordinate surveillance, and strengthen diagnostic capacities and health worker protection.

Do health crises like Ebola reveal current limits of the international humanitarian aid system, especially after USAID funding cuts? What role do international organizations like WHO and NGOs play in managing this crisis?

Added to regional instability, this epidemic comes at a time when response may be weakened by the reorganization of US aid. Quadripartite health aid cuts since January 2025—withdrawal from WHO, dissolution of USAID, reductions at the CDC, and decreased health aid to DRC and Uganda—have weakened vital systems. Experts say these cuts may have delayed detection. Now, DRC has signed a bilateral agreement with the United States (as have Rwanda and Uganda) in an ‘America First’ approach. Some health funding has been transferred to the State Department via this new agreement, promising $900 million over five years in a logic of extractive conditionality and a shift from multilateralism to transactional bilateralism between the US and DRC. This reorganization is not fully controlled; the US response to this Ebola resurgence is late and outside the UN framework. There is a deprioritization of humanist and solidarity principles in approaching response. The goal is first to protect Americans. The State Department mobilized $23 million in emergency funding and announced up to 50 clinics, but due to withdrawal from WHO, it did not indicate support for a WHO-led response, breaking with past practices. With the US exit from WHO, the Organization’s Contingency Fund for Emergencies is operationally fragile, as other donors fail to fill the gap. In this context, response must be activated by national institutions of the most affected countries, with support from WHO and NGOs, given the virus’s spread, while their means have been reduced by the US withdrawal and they operate in a hostile security environment. WHO, as per its mandate, declared the PHEIC and coordinates the response; the European Centre for Disease Prevention and Control published a risk assessment to support coordination, especially with Africa CDC. On the ground, medical NGOs like Médecins Sans Frontières and ALIMA have deployed care teams. The DRC Red Cross mobilizes volunteers for dignified and safe burials, risk communication, and community engagement. However, the humanitarian response remains far too limited to contain the epidemic. On the continental response side, Africa CDC and WHO announced a six-month joint response plan on June 5, 2026, covering June to November 2026, calling for $518 million to support African countries in early detection, prevention, and control. Based on the operational principle ‘one plan, one budget, one team’ advocated by WHO Director-General Tedros Adhanom Ghebreyesus, this plan aims for a coordinated response led by affected countries. It is a fundraising appeal relying on WHO, Africa CDC, and partners (UNICEF, UNHCR, WFP, IFRC, FIND), UN agencies, African governments, and international donors. Only $315.8 million have been pledged so far, short of the goal. Moreover, while this co-coordinated plan shows initial continental-level response, it also highlights a hybrid strategy of several African states: on one hand, they sign bilateral agreements, especially with the US, under conditional aid to support health systems and fight infectious diseases; on the other, they demonstrate capacity to coordinate multilaterally in a major crisis. Time will tell if this articulation will be sustainable.